دورية أكاديمية
أعرض في EDS

[New pacing strategies for heart failure].

التفاصيل البيبلوغرافية
العنوان: [New pacing strategies for heart failure].
عنوان ترانسليتريتد: Neue Pacing-Strategien bei Herzinsuffizienz.
المؤلفون: Beyer SE; Klinik für Elektrophysiologie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland., Imnadze G; Klinik für Elektrophysiologie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland., Sommer P; Klinik für Elektrophysiologie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland. psommer@hdz-nrw.de.; Herz- und Diabeteszentrum NRW, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland. psommer@hdz-nrw.de.
المصدر: Innere Medizin (Heidelberg, Germany) [Inn Med (Heidelb)] 2024 Jul 05. Date of Electronic Publication: 2024 Jul 05.
Publication Model: Ahead of Print
نوع المنشور: English Abstract; Journal Article; Review
اللغة: German
بيانات الدورية: Publisher: Springer Medizin Country of Publication: Germany NLM ID: 9918384885306676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2731-7099 (Electronic) Linking ISSN: 27317080 NLM ISO Abbreviation: Inn Med (Heidelb) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [Heidelberg, Germany] : Springer Medizin, [2022]-
مستخلص: In patients with a reduced left ventricular (LV) systolic function (ejection fraction < 35%) and a left bundle branch block with a QRS duration > 130 ms, cardiac resynchronization therapy (CRT) can contribute to an improvement in the quality of life and a reduction in mortality. The resynchronization is mostly achieved by pacing via an epicardial LV lead in the coronary sinus; however, this approach is often limited by the patient's venous anatomy and an increase in the stimulation threshold over time. In addition, up to 30% of patients do not respond to the intervention. New treatment approaches involve direct stimulation of the conduction system by pacing of the bundle of His or left bundle branch. This enables a more physiological propagation of the stimulus. Pacing of the left bundle branch is achieved by advancing the lead into the right ventricle and screwing it deep into the interventricular septum. Due to the relatively large target area of the left bundle branch the success rate is very high (currently > 90%). Observational studies have shown a greater reduction in the QRS duration, a more pronounced improvement in systolic function and a lower hospitalization rate for heart failure associated with conduction system pacing compared to CRT using a coronary sinus lead. These findings have been confirmed in small randomized trials. Therefore, the use of left bundle branch pacing should be considered not only as a bail out in the case of failed resynchronization using coronary sinus lead placement but increasingly also as an initial pacing strategy. The results of the first large randomized trials are expected to be released in late 2024.
(© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
References: Abraham WT, Fisher WG, Smith AL et al (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346:1845–1853. https://doi.org/10.1056/NEJMoa013168. (PMID: 10.1056/NEJMoa01316812063368)
Ajijola OA, Upadhyay GA, Macias C et al (2017) Permanent His-bundle pacing for cardiac resynchronization therapy: Initial feasibility study in lieu of left ventricular lead. Heart Rhythm 14:1353–1361. https://doi.org/10.1016/j.hrthm.2017.04.003. (PMID: 10.1016/j.hrthm.2017.04.00328400315)
Biffi M, Moschini C, Bertini M et al (2009) Phrenic stimulation: a challenge for cardiac resynchronization therapy. Circ Arrhythm. Electrophysiol, Bd. 2, S 402–410 https://doi.org/10.1161/CIRCEP.108.836254. (PMID: 10.1161/CIRCEP.108.836254)
Brignole M, Botto G, Mont L et al (2011) Cardiac resynchronization therapy in patients undergoing atrioventricular junction ablation for permanent atrial fibrillation: a randomized trial. Eur Heart J 32:2420–2429. https://doi.org/10.1093/eurheartj/ehr162. (PMID: 10.1093/eurheartj/ehr16221606084)
Brignole M, Pentimalli F, Palmisano P et al (2021) AV junction ablation and cardiac resynchronization for patients with permanent atrial fibrillation and narrow QRS: the APAF-CRT mortality trial. Eur Heart J 42:4731–4739. https://doi.org/10.1093/eurheartj/ehab569. (PMID: 10.1093/eurheartj/ehab56934453840)
Burri H (2022) Complications with left bundle branch area pacing. Heart Rhythm 19:735–736. https://doi.org/10.1016/j.hrthm.2022.01.032. (PMID: 10.1016/j.hrthm.2022.01.03235121117)
Burri H, Jastrzebski M, Cano Ó et al (2023) EHRA clinical consensus statement on conduction system pacing implantation: endorsed by the Asia Pacific Heart Rhythm Society (APHRS), Canadian Heart Rhythm Society (CHRS), and Latin American Heart Rhythm Society (LAHRS). Europace 25:1208–1236. https://doi.org/10.1093/europace/euad043. (PMID: 10.1093/europace/euad0433706184810105878)
Chen X, Li X, Bai Y et al (2023) Electrical Resynchronization and Clinical Outcomes During Long-Term Follow-Up in Intraventricular Conduction Delay Patients Applied Left Bundle Branch Pacing-Optimized Cardiac Resynchronization Therapy. Circ Arrhythm Electrophysiol 16:e11761. https://doi.org/10.1161/CIRCEP.122.011761. (PMID: 10.1161/CIRCEP.122.01176137577815)
Chen X, Ye Y, Wang Z et al (2022) Cardiac resynchronization therapy via left bundle branch pacing vs. optimized biventricular pacing with adaptive algorithm in heart failure with left bundle branch block: a prospective, multi-centre, observational study. Europace 24:807–816. https://doi.org/10.1093/europace/euab249. (PMID: 10.1093/europace/euab24934718539)
Chioncel O, Lainscak M, Seferovic PM et al (2017) Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail 19:1574–1585. https://doi.org/10.1002/ejhf.813. (PMID: 10.1002/ejhf.81328386917)
Chung MK, Patton KK, Lau C‑P et al (2023) 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure. Heart Rhythm 20:e17–e91. https://doi.org/10.1016/j.hrthm.2023.03.1538. (PMID: 10.1016/j.hrthm.2023.03.15383728327111062890)
Cleland JG, Abraham WT, Linde C et al (2013) An individual patient meta-analysis of five randomized trials assessing the effects of cardiac resynchronization therapy on morbidity and mortality in patients with symptomatic heart failure. Eur Heart J 34:3547–3556. https://doi.org/10.1093/eurheartj/eht290. (PMID: 10.1093/eurheartj/eht290239006963855551)
Cleland JGF, Daubert J‑C, Erdmann E et al (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352:1539–1549. https://doi.org/10.1056/NEJMoa050496. (PMID: 10.1056/NEJMoa05049615753115)
Cleland JGF, Daubert J‑C, Erdmann E et al (2006) Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase. Eur Heart J 27:1928–1932. https://doi.org/10.1093/eurheartj/ehl099. (PMID: 10.1093/eurheartj/ehl09916782715)
Crespo-Leiro MG, Anker SD, Maggioni AP et al (2016) European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1‑year follow-up outcomes and differences across regions. Eur J Heart Fail 18:613–625. https://doi.org/10.1002/ejhf.566. (PMID: 10.1002/ejhf.56627324686)
Cunnington C, Kwok CS, Satchithananda DK et al (2015) Cardiac resynchronisation therapy is not associated with a reduction in mortality or heart failure hospitalisation in patients with non-left bundle branch block QRS morphology: meta-analysis of randomised controlled trials. Heart 101:1456–1462. https://doi.org/10.1136/heartjnl-2014-306811. (PMID: 10.1136/heartjnl-2014-30681125678498)
Curtis AB, Worley SJ, Adamson PB et al (2013) Biventricular pacing for atrioventricular block and systolic dysfunction. N Engl J Med 368:1585–1593. https://doi.org/10.1056/NEJMoa1210356. (PMID: 10.1056/NEJMoa121035623614585)
Deshmukh P, Casavant DA, Romanyshyn M, Anderson K (2000) Permanent, direct His-bundle pacing: a novel approach to cardiac pacing in patients with normal His-Purkinje activation. Circulation 101:869–877. https://doi.org/10.1161/01.cir.101.8.869.
Diaz JC, Duque M, Aristizabal J et al (2023) The Emerging Role of Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy. Arrhythm Electrophysiol Rev 12:e29. https://doi.org/10.15420/aer.2023.15. (PMID: 10.15420/aer.2023.153817380010762674)
Diaz JC, Sauer WH, Duque M et al (2023) Left Bundle Branch Area Pacing. Electrophysiol, Bd. 9. Versus, Biventricular Pacing as Initial Strategy for Cardiac Resynchronization. JACC Clin, S 1568–1581 https://doi.org/10.1016/j.jacep.2023.04.015. (PMID: 10.1016/j.jacep.2023.04.015)
Elliott MK, Strocchi M, Sieniewicz BJ et al (2023) Left bundle branch area pacing reduces epicardial dispersion of repolarization compared with biventricular cardiac resynchronization therapy. Heart Rhythm 20:1629–1636. https://doi.org/10.1016/j.hrthm.2023.07.065. (PMID: 10.1016/j.hrthm.2023.07.06537516414)
Ferreira Felix I, Collini M, Fonseca R et al (2024) Conduction System Pacing versus Biventricular Pacing in Heart Failure with Reduced Ejection Fraction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Heart Rhythm:S1547–5271(24)00207–8. https://doi.org/10.1016/j.hrthm.2024.02.035.
Glikson M, Nielsen JC, Kronborg MB et al (2021) 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA). Eur Heart J 42:3427–3520. https://doi.org/10.1093/eurheartj/ehab364. (PMID: 10.1093/eurheartj/ehab36434455430)
Gu M, Niu H, Hu Y et al (2020) Permanent His Bundle Pacing Implantation Facilitated by Visualization of the Tricuspid Valve Annulus. Circ Arrhythm Electrophysiol 13:e8370. https://doi.org/10.1161/CIRCEP.120.008370. (PMID: 10.1161/CIRCEP.120.00837032911981)
Huang W, Su L, Wu S et al (2017) A Novel Pacing Strategy With Low and Stable Output: Pacing the Left Bundle Branch Immediately Beyond the Conduction Block. Can J Cardiol 33(1736):e1–1736.e3. https://doi.org/10.1016/j.cjca.2017.09.013. (PMID: 10.1016/j.cjca.2017.09.013)
Jastrzębski M, Kiełbasa G, Cano O et al (2022) Left bundle branch area pacing outcomes: the multicentre European MELOS study. Eur Heart J 43:4161–4173. https://doi.org/10.1093/eurheartj/ehac445. (PMID: 10.1093/eurheartj/ehac445359798439584750)
Jastrzębski M, Moskal P, Huybrechts W et al (2022) Left bundle branch-optimized cardiac resynchronization therapy (LOT-CRT): Results from an international LBBAP collaborative study group. Heart Rhythm 19:13–21. https://doi.org/10.1016/j.hrthm.2021.07.057. (PMID: 10.1016/j.hrthm.2021.07.05734339851)
Kristensen SL, Castagno D, Shen L et al (2020) Prevalence and incidence of intra-ventricular conduction delays and outcomes in patients with heart failure and reduced ejection fraction: insights from PARADIGM-HF and ATMOSPHERE. Eur J Heart Fail 22:2370–2379. https://doi.org/10.1002/ejhf.1972. (PMID: 10.1002/ejhf.197232720404)
Leclercq C, Burri H, Delnoy PP et al (2023) Cardiac resynchronization therapy non-responder to responder conversion rate in the MORE-CRT MPP trial. Europace 25:euad294. https://doi.org/10.1093/europace/euad294. (PMID: 10.1093/europace/euad2943777631310561537)
Linde C, Abraham WT, Gold MR et al (2008) Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms. J Am Coll Cardiol 52:1834–1843. https://doi.org/10.1016/j.jacc.2008.08.027. (PMID: 10.1016/j.jacc.2008.08.02719038680)
Lustgarten DL, Crespo EM, Arkhipova-Jenkins I et al (2015) His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients: A crossover design comparison. Heart Rhythm 12:1548–1557. https://doi.org/10.1016/j.hrthm.2015.03.048. (PMID: 10.1016/j.hrthm.2015.03.04825828601)
Merkely B, Hatala R, Wranicz JK et al (2023) Upgrade of right ventricular pacing to cardiac resynchronization therapy in heart failure: a randomized trial. Eur Heart J 44:4259–4269. https://doi.org/10.1093/eurheartj/ehad591. (PMID: 10.1093/eurheartj/ehad5913763243710590127)
Moss AJ, Hall WJ, Cannom DS et al (2009) Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 361:1329–1338. https://doi.org/10.1056/NEJMoa0906431. (PMID: 10.1056/NEJMoa090643119723701)
Mosterd A, Hoes AW (2007) Clinical epidemiology of heart failure. Heart 93:1137–1146. https://doi.org/10.1136/hrt.2003.025270. (PMID: 10.1136/hrt.2003.025270176991801955040)
Mullens W, Auricchio A, Martens P et al (2020) Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care: A joint position statement from the Heart Failure Association (HFA), European Heart Rhythm Association (EHRA), and European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology. Eur J Heart Fail 22:2349–2369. https://doi.org/10.1002/ejhf.2046. (PMID: 10.1002/ejhf.204633136300)
Nelson GS, Berger RD, Fetics BJ et al (2000) Left ventricular or biventricular pacing improves cardiac function at diminished energy cost in patients with dilated cardiomyopathy and left bundle-branch block. Circulation 102:3053–3059. https://doi.org/10.1161/01.cir.102.25.3053. (PMID: 10.1161/01.cir.102.25.305311120694)
Nowak B, Sinha AM, Schaefer WM et al (2003) Cardiac resynchronization therapy homogenizes myocardial glucose metabolism and perfusion in dilated cardiomyopathy and left bundle branch block. J Am Coll Cardiol 41:1523–1528. https://doi.org/10.1016/s0735-1097(03)00257-2.
Padala SK, Master VM, Terricabras M et al (2020) Initial. Electrophysiol, Bd. 6. Experience, Safety, and Feasibility of Left Bundle Branch Area Pacing: A Multicenter Prospective Study. JACC Clin, S 1773–1782 https://doi.org/10.1016/j.jacep.2020.07.004. (PMID: 10.1016/j.jacep.2020.07.004)
Raymond-Paquin A, Padala SK, Ellenbogen KA (2021) Left Bundle Branch Pacing: A Perfect Compromise? Arrhythm Electrophysiol Rev 10:241–243. https://doi.org/10.15420/aer.2021.60. (PMID: 10.15420/aer.2021.60351061758785080)
Shtembari J, Shrestha DB, Tung R, Upadhyay GA (2024) Inadvertent septal perforation during conduction system pacing device implant: a case report. Eur Heart J Case Rep 8:ytae106. https://doi.org/10.1093/ehjcr/ytae106. (PMID: 10.1093/ehjcr/ytae1063850048910946411)
Sipahi I, Chou JC, Hyden M et al (2012) Effect of QRS morphology on clinical event reduction with cardiac resynchronization therapy: meta-analysis of randomized controlled trials. Am Heart J 163:260–267.e3. https://doi.org/10.1016/j.ahj.2011.11.014. (PMID: 10.1016/j.ahj.2011.11.014223058454113034)
Skeete J, Huang HD, Mazur A et al (2024) Evolving Concepts in Cardiac Physiologic Pacing in the Era of Conduction System Pacing. Am J Cardiol 212:51–66. https://doi.org/10.1016/j.amjcard.2023.11.023. (PMID: 10.1016/j.amjcard.2023.11.02338012990)
Su L, Wang S, Wu S et al (2021) Long-Term Safety and Feasibility of Left Bundle Branch Pacing in a Large Single-Center Study. Circ Arrhythm Electrophysiol 14:e9261. https://doi.org/10.1161/CIRCEP.120.009261. (PMID: 10.1161/CIRCEP.120.00926133426907)
Sweeney MO, Hellkamp AS, Ellenbogen KA et al (2003) Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation 107:2932–2937. https://doi.org/10.1161/01.CIR.0000072769.17295.B1. (PMID: 10.1161/01.CIR.0000072769.17295.B112782566)
Sze E, Samad Z, Dunning A et al (2018) Impaired Recovery of Left Ventricular Function in Patients With Cardiomyopathy and Left Bundle Branch Block. J Am Coll Cardiol 71:306–317. https://doi.org/10.1016/j.jacc.2017.11.020. (PMID: 10.1016/j.jacc.2017.11.020293480238352572)
Tang ASL, Wells GA, Talajic M et al (2010) Cardiac-resynchronization therapy for mild-to-moderate heart failure. N Engl J Med 363:2385–2395. https://doi.org/10.1056/NEJMoa1009540. (PMID: 10.1056/NEJMoa100954021073365)
Tawara S (1906) Das Reizleitungssystem des Säugetierherzens: eine anatomisch-histologische Studie über das Atrioventrikularbündel und die Purkinjeschen Fäden. Fischer.
Upadhyay GA, Vijayaraman P, Nayak HM et al (2019) His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure. J Am Coll Cardiol 74:157–159. https://doi.org/10.1016/j.jacc.2019.04.026. (PMID: 10.1016/j.jacc.2019.04.02631078637)
Vijayaraman P, Dandamudi G, Zanon F et al (2018) Permanent His bundle pacing: Recommendations from a Multicenter His Bundle Pacing Collaborative Working Group for standardization of definitions, implant measurements, and follow-up. Heart Rhythm 15:460–468. https://doi.org/10.1016/j.hrthm.2017.10.039. (PMID: 10.1016/j.hrthm.2017.10.03929107697)
Vijayaraman P, Herweg B, Ellenbogen KA, Gajek J (2019) His-Optimized Cardiac Resynchronization Therapy to Maximize Electrical Resynchronization: A Feasibility Study. Circ Arrhythm Electrophysiol 12:e006934. https://doi.org/10.1161/CIRCEP.118.006934.
Vijayaraman P, Pokharel P, Subzposh FA et al (2023) His-Purkinje Conduction System Pacing Optimized Trial of Cardiac Resynchronization Therapy vs Biventricular Pacing: HOT-CRT Clinical Trial. JACC Clin Electrophysiol 9:2628–2638. https://doi.org/10.1016/j.jacep.2023.08.003.
Vijayaraman P, Sharma PS, Cano Ó et al (2023) Comparison of Left Bundle Branch Area Pacing and Biventricular Pacing in Candidates for Resynchronization Therapy. J Am Coll Cardiol 82:228–241. https://doi.org/10.1016/j.jacc.2023.05.006. (PMID: 10.1016/j.jacc.2023.05.00637220862)
Vijayaraman P, Zalavadia D, Haseeb A et al (2022) Clinical outcomes of conduction system pacing compared to biventricular pacing in patients requiring cardiac resynchronization therapy. Heart Rhythm 19:1263–1271. https://doi.org/10.1016/j.hrthm.2022.04.023. (PMID: 10.1016/j.hrthm.2022.04.02335500791)
Wang Y, Zhu H, Hou X et al (2022) Randomized Trial of Left Bundle Branch vs Biventricular Pacing for Cardiac Resynchronization Therapy. J Am Coll Cardiol 80:1205–1216. https://doi.org/10.1016/j.jacc.2022.07.019. (PMID: 10.1016/j.jacc.2022.07.01936137670)
Wu S, Su L, Vijayaraman P et al (2021) Left Bundle Branch Pacing for Cardiac Resynchronization Therapy: Nonrandomized On-Treatment Comparison With His Bundle Pacing and Biventricular Pacing. Can J Cardiol 37:319–328. https://doi.org/10.1016/j.cjca.2020.04.037. (PMID: 10.1016/j.cjca.2020.04.03732387225)
Young JB, Abraham WT, Smith AL et al (2003) Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA 289:2685–2694. https://doi.org/10.1001/jama.289.20.2685.
Zheng R, Yao H, Lian L (2023) His-Purkinje conduction system pacing for pacing-induced cardiomyopathy: a systematic literature review and meta-analysis. J Interv Card Electrophysiol 66:1005–1013. https://doi.org/10.1007/s10840-022-01296-9. (PMID: 10.1007/s10840-022-01296-935804257)
Left Bundle Branch Pacing Optimized Cardiac Resynchronization Therapy: A Novel Approach—PubMed. https://pubmed.ncbi.nlm.nih.gov/34332867/ . Zugegriffen: 04. März 2024.
فهرسة مساهمة: Keywords: Biventricular pacing; Bundle of His; Cardiac conduction system; Cardiac resynchronization therapy; Left bundle branch pacing
Local Abstract: [Publisher, German] Bei Patienten mit einer reduzierten systolischen linksventrikulären (LV-)Funktion (Ejektionsfraktion < 35 %) und einem Linksschenkelblock (Breite des QRS-Komplexes > 130 ms) kann eine kardiale Resynchronisationstherapie (CRT) zur Verbesserung der Leistungsfähigkeit und zur Senkung der Mortalität beitragen. Die Resynchronisation wird zumeist durch Stimulation über eine epikardiale LV-Sonde im Koronarsinus erreicht. Diese Therapie ist jedoch häufig durch Variationen des Venensystems des Patienten und durch einen Anstieg der Reizschwelle im Laufe der Zeit limitiert. Zudem sprechen bis zu 30 % der Patienten nicht auf die Intervention an. Neue Therapieansätze beinhalten die direkte Stimulation des Erregungsleitungssystems durch His-Bündel- oder Linksschenkelstimulation. Hierdurch kann eine physiologischere Erregungsausbreitung erzielt werden. Die Linksschenkelstimulation wird durch das Einschrauben einer Sonde in das interventrikuläre Septum vom rechten Ventrikel aus erreicht. Durch das relativ große Zielgebiet des linken Tawara-Schenkels ist die Erfolgsrate sehr hoch (aktuell > 90 %). Beobachtungsstudien zeigen eine im Vergleich zur Resynchronisation mithilfe einer Koronarsinussonde stärkere Reduktion der QRS-Komplex-Breite, eine ausgeprägtere Verbesserung der systolischen Funktion und eine geringere Hospitalisierungsrate der Patienten mit einer Herzinsuffizienz. Ähnliche Ergebnisse finden sich in kleinen randomisierten Studien. Insbesondere die Anwendung der Linksschenkelstimulation wird nicht nur als Ersatz nach dem Scheitern der Resynchronisation mithilfe der Koronarsinussonde, sondern zunehmend auch als initiale Strategie unterstützt. Die Ergebnisse der ersten größeren randomisierten Studien sind ab Ende 2024 zu erwarten.
تواريخ الأحداث: Date Created: 20240705 Latest Revision: 20240705
رمز التحديث: 20240705
DOI: 10.1007/s00108-024-01747-7
PMID: 38967707
قاعدة البيانات: MEDLINE
الوصف
تدمد:2731-7099
DOI:10.1007/s00108-024-01747-7